Exploring health disparities: a single-institution analysis of time to diagnosis in adolescent psoriasis patients

Psoriasis is a chronic inflammatory skin condition with many associated co-morbidities, making timely diagnosis key in patient care. This study investigates racial, ethnic, gender, and insurance disparities in the time to diagnosis of psoriasis in adolescent patients. It is hypothesized that health disparities will lead to increased time to diagnosis in patients of color and those with no insurance or public insurance as compared to private insurance. Retrospective chart review of consecutive patients (n=83) diagnosed with psoriasis between 2012 and 2022 was conducted. The study found a considerable delay in time to diagnosis for pediatric patients, averaging 371.5 days. Females exhibited longer times to diagnosis than males. This prolonged period can lead to increased physical discomfort and a greater risk of developing complications. While no statistically significant differences were found based on race or ethnicity, patients with no insurance experienced significantly longer times to diagnosis compared to their insured counterparts. Patients with a previous misdiagnosis (i.e., eczema, fungal infection, atopic dermatitis) had significantly longer times to diagnosis as well. The fact that race and ethnicity did not significantly influence time to diagnosis suggests strides in reducing health disparities within medical institutions. However, the fact that social determinants of health significantly influenced time to diagnosis suggests that low socioeconomic status correlates to delayed diagnoses and poorer health outcomes, highlighting the need for more equitable access to timely medical care for uninsured populations. Overall, this study contributes valuable insights into health disparities affecting time to diagnosis of psoriasis in adolescent patients.